This Issue Brief, based on an April 2003 Issue Dialogue, calls on grantmakers to take a leadership role in shaping the language access agenda to ensure that all individuals have equal access to quality health care. Sections include: recent immigration trends and demographic changes; the effect of language barriers on health outcomes and health care processes; laws and policies regarding the provision of language services to patients; strategies for improving language access; and roles for foundations in supporting improved language access, including examples of current activities.